Male infertility

Male infertility is a term that refers to infertility in male humans.
Male infertility is involved in a sexually paired couple's inability to conceive in a significant number of cases, which estimates ranging from 4 0-50%.

Causes

Pretesticular causes

Testicular factors

Post testicular causes

Pretesticular causes

Hypogonadism due to various causes

Drugs, alcohol, smoking

Strenuous riding (Bicycle riding, Horseback riding)

Testicular factors

Testicular factors of male infertility include:

Bad semen quality

Abnormal sperm morphology

Oligospermia

Azoospermia (complete lack of sperm in semen, can be due to scar tissue in testicle)

Factors that, in turn, affect the semen quality include:

Genetic defects on the Y chromosome

-Y chromosome micro deletions

Abnormal set of chromosomes

-Klinefelter syndrome

Neoplasm, e.g. seminoma

Idiopathic failure

Cryptorchidism

Varicocele (14% in one study)

-Trauma

-Hydrocele

Mumps

Malaria

Testicular dysgenesis syndrome

Post testicular causes

Vas deferens obstruction

Lack of Vas deferens, often related to genetic markers for Cystic Fibrosis

Infection, e.g. prostatitis

Retrograde ejaculation

Hypospadias

Impotence

Acrosomal defect/egg penetration defect

Medical history

The cornerstone of the male partner evaluation is the history. It should note the duration of infertility, earlier pregnancies with present or past partners, and whether there was previous difficulty with conception.
The history should include prior testicular (penis) insults (torsion, cryptorchidism, trauma), infections (mumps orchitis, epididymitis), environmental factors (excessive heat, radiation, chemotherapy), medications (anabolic steroids, cimetidine, and spironolactone may affect spermatogenesis; phenytoin may lower FSH; sulfasalazine and nitrofurantoin affect sperm motility), and drug use (alcohol, smoking).
Sexual habits, frequency and timing of intercourse, use of lubricants, and each partner's previous fertility experiences are important.

Blood sample

AZOOSPERMIA

For most couples trying to have a child, the finding of azoospermia - the absence of sperm in the semen - comes as a traumatic shock. In the past, little could be offered to these couples.

Obstructive azoospermia:

These men have normal sperm production in their testes, but there are no sperm in the semen due to an obstruction in the spermatic pathway.

Epididymal and vasal blocks:

Vas aplasia: 10 per cent of men with obstructive azoospermia are born with bilateral absence of the vasa deferentia.

Testicular failure

Prevention

Some strategies suggested or proposed for avoiding male infertility include the following:

Avoiding smoking as it damages sperm DNA

Avoiding drugs and medications known to cause fertility problems, like steroids and some antifungal medications.

Avoiding excessive exercise.

Avoiding exposure to environmental hazards such as pesticides and heavy metals such as lead, mercury and cadmium.

Avoiding frequent hot baths or use of hot tubs.

Avoiding tight underwear or pants.

Getting early treatment for sexually transmitted diseases.

Keeping diseases, such as diabetes and hypothyroidism, under control.

Practicing safer sex to avoid sexually transmitted diseases.

Wearing protection over the scrotum during athletic activities.

Treatment

In cases of post testicular causes, infertility may often be treated by homoeopathy. For sperm quality causes, e.g. oligospermia, there is effective medication in homoeopathy. Except for some cases of azoospermia all other causes of male infertility can be effectively treated by homoeopathy.

MENTAL RETARDATION

Signs

Children with mental retardation may learn to sit up, to crawl, or to walk later than other children, or they may learn to talk later. Both adults and children with mental retardation may also exhibit the following characteristics:

Delays in oral language development

Deficits in memory skills

Difficulty learning social rules

Difficulty with problem solving skills

Delays in the development of adaptive behaviors such as self-help or self-care skills

Lack of social inhibitors.

Class

Profound mental retardation

Severe mental retardation

Moderate mental retardation

Mild mental retardation

Borderline mental retardation

IQ

below 20

20–34

35–49

50–69

70–79

CAUSES

DOWN SYNDROME

CEREBRAL PALSY

IODINE DEFFICIENCY [CRETINISM]

MALNUTRITION

Downs Syndrome

A chromosome disorder associated either with an extra chromosome 21 or an effective trisomy for chromosome 21. Clinical manifestations include hypotonia, short stature, brachycephaly, upslanting palpebral fissures, epicanthus, Brushfield spots on the iris, protruding tongue, small ears, short, broad hands, fifth finger clinodactyly, Simian crease, and moderate to severe MENTAL RETARDATION. Cardiac and gastrointestinal malformations, a marked increase in the incidence of LEUKEMIA, and the early onset of ALZHEIMER DISEASE are also associated with this condition. Pathologic features include the development of NEUROFIBRILLARY TANGLES in neurons and the deposition of AMYLOID BETA-PROTEIN, similar to the pathology of ALZHEIMER DISEASE.

Cerebral Palsy

A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms.

Female infertility

Female infertility is a term that refers to infertility in female humans.

Causes

General factors

Hypothalamic-pituitary factors

Ovarian factors

Tubal (ectopic)/peritoneal factors

Uterine factors

Cervical factors

Vaginal factors

Genetic factors

Causes

Factors relating only to female infertility are:

General factors

Significant liver or kidney disease

Thrombophilia

Hypothalamic-pituitary factors

Hypothalamic dysfunction

Ovarian factors

Polycystic ovarian syndrome

Anovulation

Diminished ovarian reserve

Premature menopause

Menopause

Luteal dysfunction

Gonadal dysgenesis (Turner syndrome)

Ovarian cancer

Tubal (ectopic)/peritoneal factors

Endometriosis

Pelvic adhesions

Pelvic inflammatory disease (PID, usually due to Chlamydia)

Tubal occlusion

Tubal dysfunction

Uterine factors

Uterine malformations

Uterine fibroids (leiomyoma)

Asherman's Syndrome

Cervical factors

Cervical stenosis

Antisperm antibodies

Non-receptive cervical mucus

Vaginal factors

Vaginismus

Vaginal obstruction

ALZHEIMER’S DISEASE

10 warning signs of Alzheimer's:

Memory loss. Forgetting recently learned information is one of the most common early signs of dementia. A person begins to forget more often and is unable to recall the information later.
What's normal? Forgetting names or appointments occasionally.

Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, placing a telephone call or playing a game.
What's normal? Occasionally forgetting why you came into a room or what you planned to say.

Problems with language. People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for "that thing for my mouth.”
What's normal? Sometimes having trouble finding the right word.

Disorientation to time and place. People with Alzheimer’s disease can become lost in their own neighborhood, forget where they are and how they got there, and not know how to get back home.
What's normal? Forgetting the day of the week or where you were going.

Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. They may show poor judgment, like giving away large sums of money to telemarketers.
What's normal? Making a questionable or debatable decision from time to time.

Problems with abstract thinking. Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used.
What's normal? Finding it challenging to balance a checkbook.

Misplacing things. A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl.
What's normal? Misplacing keys or a wallet temporarily.

Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid mood swings – from calm to tears to anger – for no apparent reason.
What's normal? Occasionally feeling sad or moody.

Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member.
What's normal? People’s personalities do change somewhat with age.

Loss of initiative. A person with Alzheimer’s disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities.

The difference between Alzheimer's and normal age-related memory changes

Someone with Alzheimer's disease

Forgets entire experiences

Rarely remembers later

Is gradually unable to follow written/spoken directions

Is gradually unable to use notes as reminders

Is gradually unable to care for self

Someone with normal age-related memory changes

Forgets part of an experience

Often remembers later

Is usually able to follow written/spoken directions

Is usually able to use notes as reminders

Is usually able to care for self

Symptoms

The course of AD is not the same in every person with the disease, but symptoms seem to develop over the same general stages.

Very early signs and symptoms

Memory problems are one of the first signs of AD. Some people with mild AD have a condition called anmestic mild cognitive impairment (MCI). People with MCI have more memory problems than normal for people their age, but their symptoms are not as severe as those of people with AD. More people with MCI go on to develop AD than people without MCI.

Mild AD

As AD progresses, memory loss continues and changes in other cognitive abilities appear. Symptoms in this stage can include:

Getting lost

Trouble handling money and paying bills

Repeating questions

Taking longer than before to complete normal daily tasks

Poor judgment

Losing things or misplacing them in odd places

Mood and personality changes

In most people with AD, symptoms first appear after age 60. AD is often diagnosed at this stage.

Moderate AD

In moderate AD, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. Symptoms may include:

Severe AD

People with severe AD cannot communicate and are completely dependent on others for their care. Near the end, the person with AD may be in bed most or all of the time. Their symptoms often include:

Inability to recognize oneself or family

Inability to communicate

Weight loss

Seizures

Skin infections

Difficulty swallowing

Groaning, moaning, or grunting,

Increased sleeping

Lack of control of bowel and bladder

The most frequent cause of death for people with AD is aspiration pneumonia. This type of pneumonia develops when a person cannot swallow properly and takes food or liquids into the lungs instead of air.

Symptoms

Some symptoms of Alzheimer's disease include:

Abstract Thinking -- Balancing a checkbook may be hard when the task is more complicated than usual. Someone with Alzheimer's disease, however, might forget what the numbers are and what needs to be done with them.

Disorientation -- It's normal to forget the day of the week or where you're going. People with Alzheimer's disease can become lost on the street where they live, forget where they are and how they got there, and not know how to get back home.

Initiative -- People often tire of housework, business activities or social obligations at times. However, a person with Alzheimer's disease may become excessively passive, sitting in front of the television for hours, sleeping more than usual or not doing usual activities.

Judgment -- No one has perfect judgment all of the time but those with Alzheimer's disease may dress without regard to the weather, wearing several shirts or blouses on a warm day or very little clothing in cold weather. Individuals with dementia often show poor judgment about money, giving away large amounts of money to telemarketers or paying for home repairs or products they don't need.

Language -- All of us have trouble finding the right word from time to time, but people with Alzheimer's disease often forget simple words or substitute’s unusual words, making their speech or writing hard to understand. If a person with Alzheimer's is unable to find his or her toothbrush, for example, the individual may ask for "that thing for my mouth".

Misplacing Items -- Anyone can temporarily misplace a wallet or key. A person with Alzheimer's disease may put things in unusual places -- an iron in the freezer or a wristwatch in the sugar bowl.

Mood Changes -- Everyone can become sad or moody from time to time. However, someone with Alzheimer's disease can show rapid mood swings -- from calm to tears to anger -- for no apparent reason.

Personality -- Personalities ordinarily change somewhat with age but a person with Alzheimer's disease may have a severe personality change, becoming extremely confused, suspicious, fearful or dependent on a family member.

Diagnosis

There is no single diagnostic test that can detect if a person has Alzheimer's disease. The process involves several tests and may take more than a day. Tests and criteria make it possible for doctors to make a diagnosis of Alzheimer's with an accuracy of about 90 percent.

There are two abnormal structures in the brain associated with Alzheimer's disease -- amyloid plaques and neurofibrillary tangles:

Amyloid Plagues -- Amyloid plaques are sticky clumps or patches of protein found surrounded by the debris of dying nerve cells in the brain of Alzheimer's patients.

Neurofibrillary Tangles -- These are the damaged remains of protein called tau, which are required for the normal functioning of the brain. In people with Alzheimer's, threads of tau protein become twisted, which researchers believe may damage neurons and cause them to die.

Research about these structures have provided clues about why cells die, but scientists have not determined exactly what role plaques and tangles play in the disease process and whether these are the key factors.

At the UCSF Memory and Aging Center, the evaluation and treatment recommendations for Alzheimer's are performed by a specially trained team including neurologists, radiologists, pharmacists, nurses and other health professionals. Evaluations may include the following steps:

Brain Scans -- These tests will be performed to detect other possible causes of dementia such as stroke.
Evaluations -- A series of evaluations will test memory, reasoning, vision-motor coordination and language skills.

Interviews -- An interview with the patient and another person close to the patient, such as a relative, spouse or close friend who can provide examples of memory loss and functional decline.

Laboratory Tests -- Lab tests, such as blood and urine tests, may provide information about problems other than Alzheimer's that may cause dementia

Medical History -- Information about current mental or physical conditions, prescription and nonprescription drug use, and family health history will be collected.

Mental Status -- An evaluation will be conducted to assess sense of time and place; ability to remember, understand and communicate and ability to do simple math problems.

Physical Exam -- The patient's nutritional status, blood pressure and pulse will be assessed as part of this examination. Tests of sensation, balance and other functions of the nervous system also will be conducted.

Psychiatric Evaluation -- An assessment of mood and other emotional factors that could cause dementia-like symptoms or may accompany Alzheimer's disease will be completed.

ADHD

Symptoms

Impulsiveness: a person who acts quickly without thinking things through.

Hyperactivity: a person who is unable to sit still.

Inattention: a person who daydreams or seems to be in another world.

The DSM IV categorises the symptoms of ADHD into two clusters: inattention symptoms and hyperactivity/impulsivity symptoms. Most ordinary people exhibit some of these behaviors but not to the point where they significantly interfere with the person's work, relationships, or studies or cause anxiety or depression.

Hyperactivity is common among children with ADHD but tends to disappear during adulthood. However, over half of children with ADHD continue to have some symptoms of inattention throughout their lives.

Inattention and "hyperactive" behavior are not the only problems with children with ADHD. ADHD exists alone in only about 1/3 of the children diagnosed with it. Many of these co-existing conditions require other courses of treatment and should be diagnosed separately instead of being grouped in the ADHD diagnosis. Some of the associated conditions are:

Oppositional defiant disorder (35%) and Conduct disorder (26%). These are both characterized by anti-social behaviors such as aggression, frequent temper tantrums, deceitfulness, lying, or stealing.

Primary disorder of vigilance. Characterized by poor attention and concentration, as well as difficulties staying awake. These children tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert and active.

Bipolar disorder. As many as 25% of children with ADHD have bipolar disorder. Children with this combination may demonstrate more aggression and behavioral problems than those with ADHD alone.

Anxiety Disorders. Commonly accompany ADHD, particularly Obsessive-Compulsive Disorder. OCD is believed to share a genetic component with ADHD, and shares many of its characteristics.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD—an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).

Signs of inattention:

Often becoming easily distracted by irrelevant sights and sounds

Often failing to pay attention to details and making careless mistakes

Rarely following instructions carefully and completely losing or forgetting things like toys, or pencils, books, and tools needed for a task

Often skipping from one uncompleted activity to another.

Signs of hyperactivity-impulsivity are:

Feeling restless, often fidgeting with hands or feet, or squirming while seated

Running, climbing, or leaving a seat in situations where sitting or quiet behavior is expected

Blurting out answers before hearing the whole question

Having difficulty waiting in line or taking turns.

Hyperactive children always seem to be “on the go” or constantly in motion. They dash around touching or playing with whatever is in sight, or talk incessantly. Sitting still at dinner or during a school lesson or story can be a difficult task. They squirm and fidget in their seats or roam around the room. Or they may wiggle their feet, touch everything, or noisily tap their pencil. Hyperactive teenagers or adults may feel internally restless. They often report needing to stay busy and may try to do several things at once.

Motor Neuron Disease

Diseases characterized by a selective degeneration of the motor neurons of the spinal cord, brainstem, or motor cortex. Clinical subtypes are distinguished by the major site of degeneration. In AMYOTROPHIC LATERAL SCLEROSIS there is involvement of upper, lower, and brainstem motor neurons. In progressive muscular atrophy and related syndromes (see MUSCULAR ATROPHY, SPINAL) the motor neurons in the spinal cord are primarily affected. With progressive bulbar palsy (BULBAR PALSY, PROGRESSIVE), the initial degeneration occurs in the brainstem. In primary lateral sclerosis, the cortical neurons are affected in isolation.

Autism

Core symptoms

The severity of symptoms varies greatly between individuals, but all people with autism have some core symptoms in the areas of:

Social interactions and relationships. Symptoms may include:

Lack of interest in sharing enjoyment, interests, or achievements with other people.

Lack of empathy. People with autism may have difficulty understanding another person's feelings, such as pain or sorrow.

Verbal and nonverbal communication. Symptoms may include:

Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.1
Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.
Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).
Difficulty understanding their listener's perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.
Limited interests in activities or play. Symptoms may include:
An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.
Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
Stereotyped behaviors. These may include body rocking and hand flapping.

Learning Disability

The most common learning disabilities fall into five, general categories:

Dyslexia is a disorder in which there is difficulty understanding written words.

Dysgraphia involves difficulty in writing words or writing within a defined space.

Ankylosing Spondylitis

The form of rheumatoid arthritis affecting the spine. It occurs predominantly in young males and produces pain and stiffness as a result of inflammation of the sacroiliac, intervertebral, and costovertebral joints

Asthma

A form of bronchial disorder associated with airway obstruction, marked by recurrent attacks of paroxysmal dyspnea, with wheezing due to spasmodic contraction of the bronchi.

Diabetic Complications

Diabetic Nephropathy: Protein molecules along with other bodies which are present in the blood, start appearing in the urine. In the initial phase of nephropathy where damage is not too severe, Homeopathic medicine and diet can control the condition. When protein starts leaking in the urine it is called as microalbuminuria, as the condition starts worsening, large amount of protein is thrown in the urine with heavy losses of protein from the body. Few easily noticed symptoms of kidney failure are fatigue, decreased appetite, nausea and vomiting. It has been observed that about 30 to 40 % of Type I diabetics and 20 to 30 % of Type 2 diabetics develop moderate to severe kidney failure.

Diabetic Nephropathy can be screened in simple urine test at any diagnostic laboratory. Type 1 diabetic must check nephropathy test in fourth year of diagnosis and Type 2 at the time of diagnosis. It is always better to go for routine tests in the further years. When it shows albuminiuria, modification of diet, regular exercise with homoeopathic medication for blood pressure control to normal. Patients with elevated blood pressures and albuminuria are treated with homoeopathy successfully. These medications can reduce the percent of protein extraction in the urine and help in slowing down the progression of diabetes, nephropathy and related kidney diseases.

Diabetic peripheral neuropathy-symptoms

Paresthesias - abnormal sensations on the affected areas such as hand, fingers, feet and toes.

Numbness in toes

Pain in toes

Tingling in toes

Burning in toes

Numbness in hands

Pain in hands

Tingling in hands

Hand weakness

Numbness in fingers

Pain in fingers

Tingling in fingers

Numbness in feet

Pain in feet

Tingling in feet

Bedwetting

Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting; nocturnal enuresis).

Back Pain & Intervertebral Disc Prolapse

Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions.

Benign Prostatic Hypertrophy

Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells.

Depression

Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.

Irritable Bowel Syndrome

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

Crohns Disease

Gastrointestinal disorder characterized by chronic inflammatory infiltrates, fibrosis affecting all layers of the serosa, and development of noncaseating granulomas. The most common site of involvement is the terminal ileum with the colon as the second most common.

Ulcerative Colitis

Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, then bleed and produce pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea.

When the inflammation occurs in the rectum and lower part of the colon it is called ulcerative proctitis. If the entire colon is affected it is called pan colitis. If only the left side of the colon is affected it is called limited or distal colitis.

Ulcerative colitis is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the small intestine and colon. It can be difficult to diagnose because its symptoms are similar to other intestinal disorders and to another type of IBD called Crohn’s disease. Crohn’s disease differs because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system including the small intestine, mouth, esophagus, and stomach.

Dementia

An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions.

The intellectual decline is usually progressive, and initially spares the level of consciousness.

Eczema

A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents

Glaucoma

An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches.

Hypertension

Insomnia

Disorders characterized by impairment of the ability to initiate or maintain sleep. This may occur as a primary disorder or in association with another medical or psychiatric condition.

Migraine

A subtype of vascular headaches characterized by periodic unilateral pulsatile headaches which begin in childhood, adolescence, or early adult life and recur with diminishing frequency during advancing years. The two major subtypes are CLASSIC MIGRAINE (i.e., migraine with aura) and COMMON MIGRAINE (i.e., migraine without aura). Migrainous episodes may be associated with alterations in cerebral blood flow.

Stroke

A stroke, or cerebrovascular accident (CVA), occurs when blood supply to part of the brain is disrupted, causing brain cells to die. When blood flow to the brain is impaired, oxygen and glucose cannot be delivered to the brain. Blood flow can be compromised by a variety of mechanisms.

Blockage of an artery

Narrowing of the small arteries within the brain can cause a so-called lacunar stroke, (lacune=empty space). Blockage of a single arteriole can affect a tiny area of brain causing that tissue to die (infarct).

Hardening of the arteries (atherosclerosis) leading to the brain. There are four major blood vessels that supply the brain with blood. The anterior circulation of the brain that controls most motor, activity, sensation, thought, speech, and emotion is supplied by the carotid arteries. The posterior circulation, which supplies the brainstem and the cerebellum, controlling the automatic parts of brain function and coordination, is supplied by the vertebrobasilar arteries.

If these arteries become narrow as a result of atherosclerosis, plaque or cholesterol, debris can break off and float downstream, clogging the blood supply to a part of the brain. As opposed to lacunar strokes, larger parts of the brain can lose blood supply, and this may produce more symptoms than a lacunar stroke.

Embolism to the brain from the heart. In situations in which blood clots form within the heart, the potential exists for small clots to break off and travel (embolize) to the arteries in the brain and cause a stroke.

Rupture of an artery (hemorrhage)

Cerebral hemorrhage (bleeding within the brain substance). The most common reason to have bleeding within the brain is uncontrolled high blood pressure. Other situations include aneurysms that leak or rupture or arteriovenous malformations (AVM) in which there is an abnormal collection of blood vessels that are fragile and can bleed.